Key for Costliest Health Plan Members and Employee Claimants

By Pam Greenhouse

The total cost of chronic disease in American between 2016-2030 is projected to be $42 trillion, according to the Partnership to Fight Chronic Disease, with $8,600 per person in medical and productivity cost if current trends continue.

The U.S. Department of Health and Human Services Agency for Healthcare Research and Quality reports that over half of Americans are living with at least one chronic condition and nearly a third have multiple chronic conditions including congestive heart failure, diabetes, arthritis, and depression. Individuals with multiple chronic conditions are also the costliest patients, and costs increase with the number of chronic conditions: In 2010, nearly 40% of all inpatient hospital stays were for those with 5+ chronic conditions.

While these costs have skyrocketed for decades unabated, we have reached a tipping point where the evolution of mobile technology combined with video health coaching can address both the cost and quality challenges this population presents.

In the late 1990s-early 2000s, disease management programs (DMPs) began to proliferate, driven by managed care and capitation, with the aim of lowering the cost of care for chronic disease. But the challenges of patient enrollment and compliance have been significant and DMPs haven’t reached their potential. In fact, a not-insignificant number of companies have given up on DMPs for these reasons.


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By Robert E. Grant

At this year’s HIMSS (Healthcare Information and Management Systems Society) conference, which explores, shares and promotes the best use of information technology and management systems in the U.S. healthcare industry, more than 40,000 health IT professionals, clinicians, executives and vendors from around the world gathered in Las Vegas, Nevada.

Among key industry trends taking center stage, attendees, exhibitors and presenters focused on finding ways to succeed in emerging value-based care models and patient engagement. And it’s about time. With the current model based on fees for services and prioritizing insurance providers and pharmaceutical companies first, patients continue to find themselves at the bottom of a soaring $3.4 trillion industry.

With the U.S. spending more on healthcare than any other country in the world at $10,348 per person—which amounts to nearly 18 percent of gross domestic product—it is indisputable that patients continue to pay more while receiving less. In addition to an increasing number of post-mortem reports highlighting this troubling predicament, Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care released by the Commonwealth Fund puts into harsh perspective just how far America’s healthcare system has plummeted.

Rather than leading the world, the U.S. has fallen to last place on a list of the top 11 countries with similar high-income populations, scoring poorly in nearly every category, including administrative efficiency and healthcare outcomes, and reinforcing the notion that high spend is no guarantee for high quality. [Read more…]

Travel companions play an important role as advocates and caregivers

By Laura Carabello

Among those who travel across the country or around the world to seek affordable, quality healthcare, 83 percent travel with a companion. Whether undergoing treatments or recovery, the physical and moral support that these caregiver/companions bring to medical travel patients is critical.

In fact, research consistently shows that companion participation in care is associated with positive patient and physician experiences. Informal healthcare providers include friends, family, and some volunteers who provide essential unpaid care without formal training. 

At home, caregivers administer medications, manage wounds and assist with rehabilitation. In hospital settings, they perform tasks that augment care provided by nurses and physicians, such as monitoring symptoms and articulating patients’ preferences to healthcare professionals.

The support of a companion/caregiver is important in any healthcare setting, but it is especially critical in the context of medical travel where patients may face additional challenges, such as travel, an unfamiliar physical environment, a different culture and potential language barriers.

They also help to retain and transfer the patient’s medical information at a medical facility, advocate on behalf of the patient to ensure all their needs are being met, and provide a safe and positive medical travel experience.


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By Kim Bassett

Hospital executives, physicians and healthcare workers — myself included — see the hospital world from a very different view than that of the patient. The healthcare world feels normal to us.  We spend so much time in our healthcare world that it becomes our second home and family. 

For our patients and their visitors, the healthcare environment can be very confusing, challenging and even fear-provoking.  As healthcare workers, we often don’t think about the uncertainty our patients feel as they navigate the healthcare system. 

Recently, I had an opportunity to accompany a family member through her healthcare experience while undergoing elective surgery.  I spent 3 days in an unfamiliar hospital with her and spent the time watching the staff interact with her and her response to them.  She thought this hospital and its staff was the best place on earth.  She totally trusted that they were all focused on her. 

Here are five things they did that made her feel safe, secure, and cared for.    [Read more…]

By Joe Reynolds

Healthcare providers are able to treat complex and chronic diseases better than ever before thanks to continued innovations in treatment options—but unfortunately for some patients who are uncomfortable with needles, some advanced treatments are required to be injected at home. This poses an additional challenge for healthcare providers to not only help quell patient reluctance and anxiety with the prospect of injections but also to ensure continued patient compliance once patients are on their own.

Needle anxiety can be a roadblock

Research studies have illustrated what many clinicians may have long suspected: The more self-confidence a patient feels regarding self-injection, the more likely they are to adhere to their schedule for self-injection and perform it properly. As such, it’s vital to work with patients at the start of their “onboarding” period—i.e. the first 30 to 90 days of self-injection—to demonstrate proper self-injection technique. But certain shortcomings need to be addressed. Current face-to-face training sessions are usually relatively brief, with patients expected to absorb a great deal of information quickly. Also, once patients are home alone, they may not recall the proper injection method, risking their safety and potentially failing to deliver the proper dose. And if they are naturally fearful of needles, they may decide to skip their treatment altogether.

In this regard, self-injection trainers, such as those developed by Noble International, Inc., have shown to be useful. These trainers can be designed to simulate the appearance, sound and feel of actual prefilled syringes and autoinjectors in minute detail, giving patients the experience of self-injecting without actual dosing. The result has been the development of a line of patient-centric training devices that “inject” an extensive level of realism into the onboarding process. [Read more…]

By Nick Hernandez

Over the years, I have worked with many physician entrepreneurs around the country.  During this time I have noticed similarities with this very distinct breed of business professionals.  The reality for a lot of physician entrepreneurs is that their startup isn’t their only job.  Many still work full-time with their medical practice or hospital while pursuing their motivating ideas.  Consequently, there seems to be some common threads with these physicians in their early morning routines. 

For those of us who are business owners, we know that when running a business, it may seem like there are never enough hours in the day.  Successful physician entrepreneurs are obviously hard-working by nature, but they also make their habits work for them.  They do things each day that allow them to take steps forward in self-development and their career.

Tapping into the power of mornings, a time of day when there are less demands, is a key physician entrepreneurs use to increasing their productivity.  They know that they are less likely to get distracted in the morning and that their day fills up fast.  Waiting until the afternoon or evening to do something meaningful for oneself such as exercising or reading, will likely mean it is pushed off the to-do list altogether.  Physician entrepreneurs recognize that mornings give them an opportunity to set a positive tone for the day.

In the hustle and bustle of everyday life, people tend to put exercise on the back burner.  However, some of the most successful physician entrepreneurs fit this morning habit into their routines.  Dedicated physician entrepreneurs carve out time in the morning to exercise, before their workday begins.  Being physically active, specifically in the morning, is known to increase productivity.  It has been shown that exercising, even for as little as 30 minutes each morning, can make a world of difference throughout your workday.  This is due to the triggering of metabolism which remains elevated for hours, thus helping you feel energized throughout the day.  They also ensure to eat a healthy breakfast and when strapped for time, some even prepare food the night before. [Read more…]

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Infectious diseases are transmitted through the air, droplets or physical contact. Germs and viruses can easily move from one person to another. Airborne and droplets cross-contamination is often caused when an infected person coughs or sneezes. The microbes then come into contact with the nose, eyes or mouth of someone else, and the infection is spread.

There are some individuals who are more likely to be put in this situation, such as health care workers, and most hospitals and health centers have procedures in place to try and reduce the risks for them. There are not many diseases that are spread through the air, as a germ or virus needs to be able to survive for a relatively long period to remain contagious. However the infection is spread, a clean and sterile area is important. [Read more…]

By Gregory Sancoff

When a patient presents with asthma or allergy symptoms, medical professionals might face a dilemma: treat just the symptoms, or try to get to the root cause or triggers. Patients can be tested and treated for allergies and asthma triggered by a variety of contaminants like mold, allergens, formaldehyde and VOCs.

Yet without being able to gauge the levels of such substances present inside the patient’s home, it can be difficult to determine the course of treatment required. Further, it is possible that these treatments could have little to no efficacy if contaminant levels are excessive, especially mold and allergens.

This scenario is now improving with the advent of complete, fast, easy-to-use indoor air and water assessment kits that can be recommended for patient use. Using these kits, patients can provide their doctors with crucial, indoor air quality data about their home environments from professional, accredited labs.

If there is an issue with indoor air quality, one treatment approach might be to remediate the home environment instead of or in addition to other therapies. Or, if therapies are not having the desired effect, an indoor air quality test can help determine what triggers may still be present.

The importance of home testing for contaminants

There is increasing recognition that all Americans deserve to live in home environments free of mold, pests and other health hazards that can trigger asthma and allergy symptoms. For example, the Asthma-Free Housing Act, passed in late 2017 by the New York City Council, mandates landlords to clean up asthma triggers inside city apartments. [Read more…]

By Taly Dery

As has been extensively reported, risks for healthcare-associated infections (HAI) still remain high, despite updated protocols. It has been estimated that about 5 to 15 percent of all patients develop a healthcare-associated infection (HAI) in the United States per year, resulting in 99,000 deaths and an estimated $20 billion in healthcare costs. Various methods for the prevention and treatment in the hospital setting that have been studied in recent literature include a hydrogen peroxide vapor added to standard cleaning and ultraviolet environmental disinfection. Further, studies have reported that a daily oral dose of probiotics added to the standard preventative measures against C. difficile have been effective. Could probiotics also be used as an air and surface purifier in the healthcare setting?

The promise of probiotics

Probiotics have long been incorporated into a variety of foods and dietary supplements. As noted in the Annals of Nutrition & Metabolism, probiotics have demonstrated significant potential as therapeutic options; several important mechanisms underlying the antagonistic effects of probiotics on various microorganisms include the following: modification of the gut microbiota, competitive adherence to the mucosa and epithelium, strengthening of the gut epithelial barrier and modulation of the immune system to convey an advantage to the host. A clearer understanding of probiotics’ mechanism of action may uncover novel probiotic functions. [Read more…]